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posted by Fnord666 on Wednesday January 30 2019, @05:45PM   Printer-friendly
from the intense-pressure-control dept.

Arthur T Knackerbracket has found the following story:

Intensive control of blood pressure in older people significantly reduced the risk of developing mild cognitive impairment (MCI), a precursor of early dementia, in a clinical trial led by scientists at Wake Forest School of Medicine, part of Wake Forest Baptist Health.

However, the National Institutes of Health-supported Systolic Blood Pressure Intervention Trial (SPRINT) Memory and Cognition in Decreased Hypertension (SPRINT MIND) study did not prove that treating blood pressure to a goal of 120 mm Hg or less statistically reduced the risk of dementia. This result may have been due to too few new cases of dementia occurring in the study, the authors noted.

The results were reported in the Jan. 28 edition of the Journal of the American Medical Association.

MCI is defined as a decline in memory and thinking skills that is greater than expected with normal aging and is a risk factor for dementia. Dementia is defined as a group of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person's ability to perform everyday activities.

"As doctors treating older patients, we are encouraged to finally have a proven intervention to lower someone's risk for MCI," said the study's principal investigator, Jeff Williamson, M.D., professor of gerontology and geriatric medicine at Wake Forest School of Medicine. "In the study, we found that just three years of lowering blood pressure not only dramatically helped the heart but also helped the brain."

[...] Williamson said some caution should be exercised in interpreting the study result both because MCI was not the primary cognitive focus of the trial and because it is not clear what intensive blood pressure control may mean for the longer-term incidence of dementia. Although MCI considerably increases the risk of dementia, this progression is not inevitable and reversion to normal cognition is possible, he said.

Jeff D. Williamson, et. al. Effect of Intensive vs Standard Blood Pressure Control on Probable Dementia. JAMA, 2019; DOI: 10.1001/jama.2018.21442

-- submitted from IRC


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  • (Score: 0) by Anonymous Coward on Wednesday January 30 2019, @06:05PM (1 child)

    by Anonymous Coward on Wednesday January 30 2019, @06:05PM (#794161)

    This number is "magical". Is the procedure that resulted in that number the one used by the current study?

    Actually this is the best description I could find for what they did to measure blood pressure (in supplement 1):

    5.3.1 Seated Blood Pressure and Pulse
    Seated blood pressure and pulse are measured at each clinic visit after a rest period
    using an automated device or manual devises if necessary. The preferred method is the
    automated device as it offers reduced potential for observer biases and decreased
    demand on staff in terms of training and effort in data collection.

    https://jamanetwork.com/journals/jama/fullarticle/2723256 [jamanetwork.com]

    So the subjects were seated, that is pretty much all we know.

    Was the arm on an armrest, held out straight, etc? How high was the armrest relative to heart level? Wouldn't that be different for each subject? What was the automated device model and how/when was it calibrated? How many measurements did they make? How long was the rest period? Were the subjects legs allowed to be crossed? Could the subjects see the display as the cuff was inflating/deflating? Were they always sure not to talk during the measurement?

    And yes all those things can push the blood pressure reading up/down 10-20 mmHG easy. They don't even describe the most basic aspects of what they did but go on to write endless pages of speculation about the numbers they generated.

  • (Score: 0) by Anonymous Coward on Thursday January 31 2019, @02:41AM

    by Anonymous Coward on Thursday January 31 2019, @02:41AM (#794351)